Pollock, A. Medicating Race: Heart Disease and Durable Preoccupations with Difference, Durham and London: Duke University Press. 2012. ix + 265pp 16.99 (pbk) ISBN: 978‐0‐8223‐5344‐7

In this fascinating and wide-ranging book, Pollock reads race across time and through a range of social and epistemological projects and spheres using the lens of heart disease in the United States. The work is theoretically sophisticated (drawing on Derrida, Foucault and Marx) and empirically rich, based on historical and contemporary ethnographic research that ranges across such diverse topics as the early professionalisation of cardiology; the Framingham and Jackson Heart Studies; debates around Thiazide diuretics; and the racially-marketed drug, Bidil. Informed by Derrida's semiotics, this work offers multiple readings of what race is, as ‘repetition with a difference’. Pollock describes race as a ‘durable preoccupation’, a site of meaning and practice that is deeply affective and occupying. Hence, while the form and content of how race is understood and enacted and discursively produced changes, what remains is the preoccupation, a shared sense that it deeply matters. This book is masterfully performative and empirically rich, offering insight to scholars of race, feminist science and technology studies, medical anthropology and sociology. Chapters 2 and 3 focus on normalization, disease categories, and medical practice. Together they trace the normalization of race in and between public health (through the Framingham and Jackson Studies), the insurance industry, and clinical medicine. A central message here is that race has considerable durability because it is recordable, and that this recordability provides a powerful rationale for intervention, despite the considerable and eclectic unsettled debates about what race is. Throughout the book, Pollock argues that race is simultaneously biological, semiotic, material and social, and that science is unable to provide a settled truth. One of the many valuable contributions lies in reframing the relationship between biologisation and naturalisation, cognisant with recent moves in sociology and anthropology to address the body's materiality. While historically biology was seen as immutable and therefore biological explanations as determinist, contemporary framings of the body as a plastic site of intervention means that biological explanations are not reifying in the same way. Together, Chapters 5 and 6 consider intersections of race, pharmaceuticals (the generic, thiazide and the brand name Bidil, respectively) and capitalism to make important contributions to social sciences literatures on pharmaceuticals and citizenship. Chapter 5 traces discourses around prescription of thiazides for African American hypertensive patients on the grounds that they are ‘racialised, proven, old and cheap’ as reflecting their exclusion from a society where citizenship is defined through consumer access to the new and brand-name. Extending this analysis in chapter 6, Pollock shows how the racialisation of the drug, Bidil, which was integral to FDA approval, nonetheless was part of its failure to reach consumers; in part, because African Americans have not been incorporated into registers of consumerism that are key to citizenship in the US. Together, these chapters extend previous analyses of pharmaceuticals which have focused primarily on the role of the pharmaceutical industry in the ever expanding market for lifestyle drugs. By shifting debate from market value to symbolic value of drugs, and focusing on a drug for an extremely sick and delimited patient population, Pollock sheds light on previously understudied symbolic and material registers of the success or failure of pharmaceuticals. I consider Chapter 4 and the Conclusion together because I see them as central to Pollock's project. Beyond conceptualizing race, Pollock proposes an ethics of critical scholarly engagement with race through ethical non-innocence. Ethical non-innocence requires analysing race and pharmaceuticals as Derridian undecidables: as simultaneously having salutatory and harmful aspects that must be considered together. This is her response to the many activists, physicians, researchers, and citizens she presents throughout the book as they take sides in racial debates. She uses a number of resonant metaphors for taking sides – whacking moles in the game ‘whack-a-mole’, or cutting the heads off the many headed hydra, as ineffective ways to fight racism – because another mole will pop up elsewhere, another head will grow. What is required instead is to unplug the game where the cord, presumably, is racial preoccupation. Yet it is unclear who can occupy the position of ethical non-innocence. Pollock presents taking sides in racial debates as whacking moles rather than reaching for the cord; taking sides is ultimately futile because it fails to address the complexity of racialised issues and the underlying cause of racism, our durable pre occupation with it. Racism will persist, for Pollock, as long as this preoccupation does. One is left with a sense of disconnect between this preoccupation and political projects, various positioned ‘whacks’ at race to address race in the world. I am left struggling for some kind of connection between preoccupation and its historical manifestations in discourses. What is missing is a sense that historically, political action has effected how race is lived and experienced, despite continuing preoccupation.

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